What is the piriformis muscle?
Piriformis muscle is a flat muscle located deep in the gluteal region and attaches into the femur (thigh bone). The piriformis muscle acts as a hip abductor (moving away from body) when the hip is flexed as well as external rotator when it’s extended (turning the leg and foot outwards). Piriformis muscle plays an important role in hip stability, which is essential when walking, climbing up stairs, shifting weight from one foot to another as well as hip and leg motions used in various sports.
The sciatic nerve emerges from the lumbar spine (lower portion of the spine), runs underneath the piriformis muscle and extends down the thigh and leg supplying the muscles of the lower limb.
Piriformis syndrome is a condition in which the piriformis muscle compresses on the sciatic nerve causing pain in the buttocks.
Signs and Symptoms of piriformis syndrome:
Causes of Piriformis syndrome:
Piriformis syndrome is generally caused by tightness or spasm in the muscle due to overuse or injury. The following are possible causes:
How is it diagnosed?
Piriformis syndrome is usually diagnosed based on patient’s history of symptoms and clinical presentation. There are some clinical tests that can be done during physical examination, which may elicit the symptoms of piriformis syndrome. This includes the FAIR test (Flexion, adduction, Internal rotation), testing piriformis muscle or stretching it, which may irritate it and/or provoke the sciatic nerve. However tests should be done to rule out Disc Herniation or spinal stenosis.
Piriformis Syndrome that is not due to trauma but rather secondary causes such as prolonged sitting especially on hard surfaces, physical activity, poor training mechanics.. etc can be prevented.
Prevention strategies include:
Conservative treatment is usually done through physiotherapy or chiropractic treatments which such as:
Piriformis syndrome has very good prognosis and conservative treatment through physiotherapy and rehabilitation programs have shown to be very effective resolving the symptoms.